Utility of neuroimaging in postpartum headache work-up: case report and diagnostic considerations

Abstract

A postpartum headache is commonly seen in clinical practice, especially after a subarachnoid block. Generally, it is treated as a postdural puncture headache. We report on a case of a 24-year-old primigravida who underwent emergency Caesarean delivery under spinal anaesthesia. She developed a headache on the third postoperative day, which responded to conservative management. On the sixth day, she developed a severe headache which did not respond to analgesics and bed rest. Magnetic resonance imaging of the brain revealed a subdural haematoma. In such situation, there is a need to consider other differential diagnoses other than that of a postpartum headache and to conduct early neuroimaging, since the headache may be the first indication of an unsuspected, potentially fatal lesion.